| NPI | 1942363296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A6087) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: CA 20A6087) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2011-07-21 |